Small Bowel Obstruction Caused by Acute Invasive Enteric Anisakiasis

Abstract

Anisakiasis usually occurs in the stomach and can easily be diagnosed by digestive tract endoscopy as opposed to enteric anisakiasis which is very rare and difficult to be diagnosed definitively. The most important and useful tool in diagnosing enteric anisakiasis is obtaining an accurate patient history of having eaten raw fish before the onset of symptoms. We report a case of small bowel obstruction caused by acute invasive enteric anisakiasis. A 60-year-old woman visited the emergency room suffering from sudden abdominal pain. She had eaten raw fish 1 day before the onset of symptom. Radiologic studies showed small bowel obstruction. However, no definitive cause could be found. An emergency laparotomy revealed edematous and dilated proximal jejunum and a focal stenosis of the distal jejunum. Segmental resection of the jejunum was performed, and histopathological examination revealed enteric anisakiasis. The patient was discharged on the 7th day after surgery following an uneventful course of recovery. (Korean J Gastroenterol 2010; 56:192-195)

Unusual cause of small intestine obstruction in a child

“…3 In all reported cases of enteric anisakiasis resection of involved intestine has been performed due to bowel stenosis or perforation. [3][4][5][6]9,10 In our case there was no perforation or significant obstruction and resection was not performed. Cases of intestinal intussusceptions due to anisakiasis have also been reported.…”

A Case of Duodenal Anisakiasis with Duodenal Ulcer

“…Anisakiasis is classified as either the luminal or the invasive form, according to the presence of bowel wall invasion by Anisakis larvae 2. The luminal form does not cause major clinical symptoms, but the invasive form can.…”

“…The former ranges from isolated urticaria and angioedema to life-threatening anaphylactic shock associated with gastrointestinal symptoms (gastroallergic anisakiasis). Allergic reactions can occur after primary infection, solely through the presence of Anisakis allergens in food 1,2. Tissue damage is due to invasion of the gut wall and development of eosinophilic granuloma, ulcer, or perforation 2,3.…”

“…Allergic reactions can occur after primary infection, solely through the presence of Anisakis allergens in food 1,2. Tissue damage is due to invasion of the gut wall and development of eosinophilic granuloma, ulcer, or perforation 2,3. Cases of gastric anisakiasis (95%) are more common than those of enteric anisakiasis, and the latter is rarely reported 4…”

Parametrial Anisakidosis

“…Because of the nonspecific nature of these symptoms, intestinal anisakidosis has frequently been misdiagnosed as acute appendicitis, Crohn's disease, or colon cancer, occasionally resulting in unnecessary laparotomy and bowel resection. In chronic intestinal anisakiasis, the formation of eosinophilic granulomas around the larvae may present as intestinal obstruction or tumor (18,22), with resultant segmental colitis, small bowel obstruction, intussusception, or intestinal perforation presenting as acute abdomen (23)(24)(25)(26)(27). Intestinal anisakidosis may also present as eosinophilic gastroenteritis (28).…”